CREDIT APPLICATION FORM

Note: It is important that this form is completed in full, as insufficient information may result
in unnecessary delay in processing your application. All terms and condition stated overleaf
are deemed to be part(s) of this application and have been read, understood and accepted by
you in total at time of your credit facilities at (NEO+ Waru Sidoarjo)

Name of Company: Nature of Business:

Address: Phone:

Fax:
Type of company : SOLE PROPRIETER / PARTNERSHIP / PRIVATE / PUBLIC
(Delete as appropriate )

Authorized Capital Paid Up Capital No. of Employees

Particular of person authorized to make hotel arrangements, issue instruction and sign on
behalf of company:

ID or Passport
No. Name Position Signature
Number
1.
2.
3.
4.

Note: Please NOTIFY (NEO+ Waru) in writing for any changes to or in the composition of
the above list of authorized signatory immediately. Until the time that the Hotel has been
informed officially and writing by the company of any changes, the Hotel will continue to accept
the signatures and instructions of the above listed and hold the company liable for any charges
so incurred.

Company’s Bankers : Account No :

(Please state Branch)

Company’s Bankers : Account No :

(Please state Branch)

Company’s Bankers : Account No :

(Please state Branch)

Jl. S.Parman No. 52 – 54 Waru, Sidoarjo, Jawa Timur Indonesia 61256

+62 31 3000 7999 warusidoarjoInfo@NeoHotels.com
warusidoarjo.NeoHotels.com
Does your company presently have or previously had an account with another Hotel in
Surabaya?
If Yes please furnish the following particulars:

No Name of Hotel Approved Credit Limit

1.
2.
3.
4.

CREDIT LIMIT AMOUNT REQUESTED :

TERM OF PAYMENT :

The undersigned (an authorized signatory) hereby request that a corporate account be opened
for the company. In connection with the above particulars, the undersigned authorized, the
receipt and exchange of credit information. The company will be held liable for any and all
charges incurred by company’s guests staying at or entertaining at NEO+ Waru Sidoarjo on
the instructions of any of the above signatories, unless otherwise instructed in writing. The
company will be bound by the terms and conditions stated overleaf upon approval of the
application for credit at NEO+ Waru Sidoarjo

For and ON BEHALF of the company

Name : Signature:
Company stamp

Position:

General Manager Chief Accounting

□

Jl. S.Parman No. 52 – 54 Waru, Sidoarjo, Jawa Timur Indonesia 61256

+62 31 3000 7999 warusidoarjoInfo@NeoHotels.com
warusidoarjo.NeoHotels.com
TERMS AND CONDITIONS

The following terms and conditions are integral parts of the application for credit facilities at
NEO+ Waru Sidoarjo

1. The granting of credit facilities shall be at the sole discretion of NEO+ Waru Sidoarjo

2. All charges incurred by the company shall be billed to its business address and
settlement of outstanding shall be payable within fifteen (15) days from presentation
of bills.

3. The company aggresses to inform NEO+ Waru Sidoarjo of any changes to the
particulars given on the application in writing. Until such time that the hotel has been
informed in writing of any changes, the company will be held liable for any and all
charges incurred.

4. Only the authorized person listed on the application shall make arrangements for
accommodation, food and beverage consumption, etc. at NEO+ Waru Sidoarjo It is
strongly require that all instruction given to the hotel be made / confirmed in writing.

5. Interest charges and collection fees: interest on outstanding balance will be charged at
the rate of 2.5 % per month and will continue to be charged until payment is received.
Any expenses including, but not limited to, lawyers fees or court fees incurred in
connection with the collection of monies due to NEO+ Waru Sidoarjo shall be the
responsibility of the company (noted above); the company (noted above) will process
payment accordingly upon receipt of invoice from NEO+ Waru Sidoarjo

6. Should the approved credit limit be exceeded the difference is payable by the
Company immediately

7. The credit limit of the company shall be reviewed periodically and the hotel reserves
the right to withdraw, suspend or to increase the credit facilities at any time. Notification
of such action will be made in writing informing the company of the hotel’s decisions
without having to assign any reason whatsoever.

8. The company undertakes to reimburse and to indemnify the hotel for any and all losses
and damages suffered by the hotel due to non – payment of any outstanding bills and
for losses, expenses and damages caused directly or indirectly through negligence and
/ or from malicious actions of the company and/ or its guests.

9. All cheques shall be crossed and made payable to respectively hotel accounts.

10. In case this application has been faxed to NEO+ Waru Sidoarjo the original must be
sent by courier or mail.

Jl. S.Parman No. 52 – 54 Waru, Sidoarjo, Jawa Timur Indonesia 61256

+62 31 3000 7999 warusidoarjoInfo@NeoHotels.com
warusidoarjo.NeoHotels.com